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Scope Procedure To Break Up A Kidney Or Ureter Stone

New Jersey rates for HCPCS 52356

A thin scope is passed up through the urinary tract to reach a stone in the ureter or kidney, where a laser or other device breaks it into smaller pieces that can pass or be removed. This version also includes placing a temporary stent in the ureter afterward to help urine drain while the area heals.

Rates data updated July 2026.

How much does Scope Procedure To Break Up A Kidney Or Ureter Stone cost?

$7,547

Typical total for the visit. In New Jersey, July 2026.

Insurers have agreed to pay about $7,547 for this procedure. That total is two separate charges: $468 to the doctor who performs it, and $7,079 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$468$407 to $776
Facility feeThe hospital or surgery center$7,079$5,754 to $9,550

How much rates vary

Facilitymedian $7,079 · 10th to 90th $2,818 to $11,749Professionalmedian $468 · 10th to 90th $363 to $6,026
$500$1K$2K$5K$10K$20Kfacility $7,079professional $468

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$7,079.46
Typical High
$11,748.98
Aetna
Setting
Facility
Modifier
22 · Increased work
Typical Low
$9,120.11
Median
$9,120.11
Typical High
$9,120.11
Aetna
Setting
Facility
Modifier
50 · Both sides
Typical Low
$933.25
Median
$6,760.83
Typical High
$8,912.51
Aetna
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$467.74
Typical High
$6,918.31
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$389.05
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$1,148.15
Median
$2,454.71
Typical High
$11,748.98
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$741.31
Typical High
$1,071.52
Cigna
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$588.84
Typical High
$1,096.48
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$512.86
Typical High
$676.08
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,311.31
Median
$14,454.40
Typical High
$23,442.29
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$467.74
Typical High
$1,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$8,709.64
Typical High
$19,498.45
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$457.09
Typical High
$870.96

Where New Jersey sits

The same service costs 5.1 times more in Wyoming than in Arkansas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Physician feeFacility fee

New Jersey· 27th of 51

$7,547

$468 physician + $7,079 facility

WY $14,876AR $2,907

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.